Table 3:

Sample NHBE Survey Questions

Survey	Questions	Response Options
Operations	What types of residential units are provided at your property?	Single Occupancy, Double Occupancy, Triple Occupancy, Quadruple Occupancy, Other
Operations	Which of the following are provided in a typical [single occupancy, double occupancy, triple occupancy, quadruple occupancy] RU?	Kitchen/Kitchenette Area, Living Room/Seating Area, Private Bathroom, Semi-Private Bathroom (Shared with one other RU), Washing Machine and Clothes Drier in RU, Direct Access to an Outdoor Patio/Balcony Area, Windows that Can Be Opened for Fresh Air, None of the Above
Operations	What populations have their own “neighborhoods”?	Skilled Nursing, Long Term Care, Memory Care, Other Secure Care, COVID-19 Positive Care, Quarantine/Watch, Specific Nationalities/Language Speakers, Gender Specific
Operations	What RESIDENT accommodations are provided within the boundary of each neighborhood?	Dining Room, Gathering Spaces Kitchen, Laundry Room, Outdoor Patio Area, Therapy Bathing Rooms, Therapy Rooms, Treatment Rooms, Nurse Station, Other
Operations	What STAFF accommodations are provided within the boundary of each neighborhood?	Break Room, Locker Room, Decontamination Room, Hand Washing Station(s), Staff Bathrooms, Outdoor Patio Area, Sleeping Rooms, Office Space, Other, None of the Above
Facilities	Which date range includes the original year of construction of the facility?	Before 1950, 1951 to 1979, 1980 to 1995, 1996 to 2005, 2006 to 2016, 2017 to present
Facilities	How many different [HVAC] system TYPES does your facility have?	1, 2, 3, 4, 5
Facilities	Does [each specific HVAC] system serve common areas, residential units, or both?	Common Areas, Residential Units, Common Areas and Residential Units.
Facilities	What is the highest level of filtration media being used by [each specific HVAC] system currently?	Filters with a Minimum Efficiency Reporting Value (MERV) rating of 1 to 6, Filters with a MERV rating of 7 to 12, Filters with a MERV rating of 13 to 16, Filters with a MERV rating of 17 to 20, HEPA (High Efficiency Particulate Air) Filters, HEGA (High Efficiency Gas Absorption) Filters, No Filters Used, Don’t Know, Other
Facilities	How is ventilation provided for the areas served by [each specific HVAC] system?	No Ventilation Provided, Ducted Return Air System, Operable Windows, Passive Return Air System, Ducted Bathroom Vent Fans (Operated by Switch), Ducted Bathroom Vent Fans (Continuous Operation), Don’t Know, Other